Reader survey reveals some positive signs but much room for improvement

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Andrew Tucker recently had his first medical check-up in seven years. He's not a big fan of doctor visits so he kept putting off his exam.

"I don't like to go," he says, "and I'm afraid of what they might find."

Check-ups, while not necessarily recommended annually anymore, are usually advised at least every few years for someone of Tucker's age, 45, to measure things like blood pressure and cholesterol. Tucker's recent doctor visit included a prostate check with a digital rectal exam, which he "didn't find to be pleasant."

Tucker's sentiments are shared by plenty of men, so his story isn't all that surprising — except for the fact that he's a physician himself.

So how does Tucker, director of sports medicine at Union Memorial Hospital in Baltimore and head team physician for the Baltimore Ravens, explain himself?

Is there doctor-despising DNA on the Y chromosome? Or does American society produce macho men who simply don't worry about their health — or don't show their concern — until something goes wrong?

It's long been believed that many men have their heads in the sand when it comes to their health — that they don't go to the doctor or make healthy lifestyle changes unless something's broken, and then only after much prodding from the women in their lives. It's one of the reasons some legislators, doctors and men's health advocates are pushing for a federal Office of Men's Health within the Department of Health and Human Services.

Like previous studies, a new Men's Health magazine/MSNBC.com reader survey also found that men often aren't doing enough to stay healthy and fit. But the survey revealed some surprising results — that men may be taking more charge of their health, at least in some areas.

The survey, which received more than 16,300 responses during one week in October, found, for example, that 83 percent of respondents don't smoke, 78 percent know their blood pressure level and 60 percent know how high their cholesterol is.

"There seems to be a real awareness out there of what men need to know," says Peter Moore, executive editor of Men's Health.

Experts say men's awareness of health matters has increased because of more widespread media coverage over the last decade or so, and also in part because of the proliferation of pharmaceutical advertising, for products such as Viagra and Lipitor, that gets men's attention.

If it ain't broke...
But that awareness doesn't always translate into practice. For example, the survey found that while a full two-thirds of men said they went to the doctor in the past year, 4 percent hadn't gone in more than five years and 2 percent in more than 10 years. Three percent said they couldn't remember the last time they went, and 4 percent said they just don't go to doctors.

Feeling fine was the most common reason for not going to the doctor. Others included lack of health insurance, no time, mistrust of doctors, and fear of getting bad news.

And while it would be hard to miss the messages about the importance of exercise, just 48 percent of respondents said they exercise three or more times a week. A little more than a quarter said they exercise just once a month or less. And some men have gone very long stretches on the couch: 24 percent have let more than a year go by without working out, while 21 percent said two to six months lapsed between bouts of exercise.

The main excuse for not exercising, cited by 33 percent of respondents, was lack of time due to work. Other reasons included being injured, not liking to exercise and preferring to watch sports rather than play them.

Men's Health/MSNBC readers also struggle to deal with stress, according to the results. Just 53 percent of respondents said they schedule time for themselves to unwind.

A rosier picture
Still, the survey results paint a healthier picture of men than most scientific research, says Dr. Noel Bairey Merz, a cardiologist at Cedars-Sinai Medical Center in Los Angeles who studies gender differences in medicine.

Studies that sample the population at random — and are therefore more representative of average American men — indicate that about a quarter of men smoke, for instance, compared with 17 percent in the reader survey. And research shows that a quarter of the population gets exercise three or more times a week, while the survey found that about half of men do.

That's likely due to the demographics of the survey respondents, most of whom were highly educated, Bairey Merz says. Men who are educated tend to take better care of themselves.

Men's Health readers also are a more health-conscious bunch than average, notes Moore.

Overall, though, women do a better job than men when it comes to taking care of themselves, experts say. That's evident not only by the fact that women seek medical care more often, Bairey Merz says, but also that they live longer — often a decade more — than men.

To some degree, men may be at a disadvantage for reasons that aren't their fault. Doctors know, for example, that newborn boys have a higher mortality rate than girls, which could be due to a weaker immune system in males that contributes to more deadly infections, according to Bairey Merz. Adult women are known to have more conditions like scleroderma and lupus that result from a super-charged immune system.

Toughing it outBut to a significant extent, the gender gap in longevity likely stems in part from women taking better care of themselves, she says. Part of that is because women have more structured interactions with the health-care system, whether it's getting routine Pap smears or prenatal care. But beyond that, women tend to be more health-conscious, she says.

Society also plays a role in how well men take care of their health, notes Dr. Irving Herling, an associate professor of medicine at the University of Pennsylvania in Philadelphia. For example, men may not feel the same pressures to slim down as women. "I think in men it's more acceptable to be overweight," he says.

And men are often taught to just tough it out, says Men's Health Network spokesperson Harry Howitt, a U.S. Army psychologist at Fort Sam Houston in San Antonio, Texas. It starts early with many young boys pressured to hide their tears, he says.

Another reason men may not take steps to maintain their health is that they believe they're essentially invincible, says Howitt. "Young men think they'll live forever," he says.

Unfortunately, the wake-up call for men often comes late in the game, when they've had a heart attack or been diagnosed with a chronic condition like diabetes that requires major lifestyle change.

On the upside, a younger generation of guys seems to be taking note, according to Herling. He says he's seeing more male patients interested in knowing what they can do to avoid getting heart attacks — like their fathers did.

As for Tucker, he says it won't be another seven years before he sees his doctor again. The more he ages, he says, the more he stares mortality in the face.

Plus, he's not just living for himself. "I'm responsible to three kids and a wife," he says.